| NPI | 1164582821 |
|---|---|
| Doing Business As | EPSDT |
| Entity Type | Organization |
| Authorized Contact | SUZIE LASSITER Director Of Facility 601-477-9384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 374700000X Technician (Licence: MS ESS-BMR) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2008-06-17 |